Baseline Craving Strength as a Prognostic Marker of Benefit from Smartphone App-Based Mindfulness Training for Smoking Cessation

Abstract

Mindfulness training for smoking cessation may work by lessening the association between craving and smoking. However, no studies have tested whether baseline craving may be an indicator of individual smokers who might benefit more from receiving mindfulness training. This study evaluated baseline craving strength and frequency as treatment moderators in a randomized controlled trial for smoking cessation comparing mobile (smartphone-based) mindfulness training plus ecological momentary assessment (MMT-EMA) to ecological momentary assessment (EMA). Participants included 325 adult smokers (71.7% female; 81.4% White; mean age = 41.27). Craving strength and frequency were assessed with the Craving Experiences Questionnaire. Smoking was measured as cigarettes per day (CPD) at baseline and six-month follow-up. Moderated regression models were conducted. There was a significant interaction between treatment group and craving strength, but not craving frequency, in the prediction of smoking. Follow-up analyses indicated that baseline craving strength predicted benefit from receiving MMT-EMA, such that higher craving strength at baseline was significantly associated with greater reductions in CPD from baseline to six months in the MMT-EMA group, but not in the EMA group. Findings suggest that baseline craving strength may be a prognostic marker of benefit from smartphone app-delivered mindfulness training for smoking cessation. Future work is warranted for understanding baseline craving as a moderator of mindfulness training for smoking cessation.